Tariff discount application form

See how you can apply for a water tariff discount.

Please provide account details

Account Number *

Meter Number

Please provide your supply address

Address 1 *

Address 2 *

Address 3

Address 4

County *

Please provide contact details

Company name *

Contact Name *

Phone Number *

Email address *

Your issue notice details

Notice start date

Notice end date

Tick the box to list additional supply addresses. If you have had more than 1 WPRN impacted by a Water Quality Notice, or if the same WPRN has been impacted by multiple water quality notices you can add these here.

2nd Supply Address

Address 1

Address 2

Address 3

Address 4

County

Notice start date

Notice end date

3rd Supply Address

Address 1

Address 2

Address 3

Address 4

County

Notice start date

Notice end date

4th Supply Address

Address 1

Address 2

Address 3

Address 4

County

Notice start date

Notice end date